{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T16:13:47Z","timestamp":1778170427634,"version":"3.51.4"},"reference-count":70,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi260351-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Circadian rest-activity rhythms (RARs) are increasingly viewed as aging-relevant behavioral phenotypes, but links to DNA methylation\u2013based epigenetic age acceleration (EAA) are not well defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260351-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate associations between multidimensional actigraphy-derived 24-hour RAR metrics (strength and robustness, regularity and fragmentation, and timing) and EAA across 4 epigenetic clocks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260351-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This cross-sectional study used data from the Baltimore Epidemiologic Catchment Area Study, wave 5 (2017-2022). The cohort included community-dwelling adults in eastern Baltimore, Maryland, with 7-day wrist actigraphy and blood DNA methylation data. Analyses were conducted from January to December 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260351-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Seven-day wrist actigraphy\u2013derived parametric and nonparametric RAR metrics, including rhythm strength and robustness (amplitude, mesor, relative amplitude, and mean activity during the least active continuous 5-hour period [L5] and most active continuous 10-hour period [M10]), regularity and fragmentation (interdaily stability [IS] and intradaily variability [IV]), timing (acrophase, L5 and M10 start times, and rest and sleep midpoints), and day-to-day timing variability (rest midpoint variability [RMV] and sleep midpoint variability [SMV]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260351-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Associations between EAA for 4 clocks (Horvath, Hannum, PhenoAge, and GrimAge) and each RAR metric, evaluated using linear regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260351-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 207 participants were included (mean [SD] age, 68.42 [7.48] years; 135 [65.2%] female). In fully adjusted models, each 1-SD increase in amplitude, relative amplitude, and IS was associated with lower GrimAge acceleration (amplitude: \u03b2, \u22120.67 [95% CI, \u22121.24 to \u22120.09];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.02; relative amplitude: \u03b2, \u22120.77 [95% CI, \u22121.31 to \u22120.23];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.005; IS: \u03b2, \u22120.65 [95% CI, \u22121.20 to \u22120.09];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.02). Each 1-SD increase in amplitude and IS was also associated with lower PhenoAge acceleration (amplitude: \u03b2, \u22121.20 [95% CI, \u22122.26 to \u22120.15];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.03; IS:  \u22121.35 [95% CI, \u22122.36 to \u22120.34];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.009). Higher L5 activity and IV were associated with higher GrimAge acceleration (L5: \u03b2, 0.60 [95% CI, 0.06-1.13];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.03; IV: \u03b2, 0.72 [95% CI, 0.17-1.28];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.01). There were nonsignificant but directionally consistent outcomes for the Horvath and Hannum clocks. RAR-EAA effect sizes were generally larger in women than in men (amplitude, mesor, M10, RMV, and SMV;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.05 for interaction) and in White participants compared with those in other race and ethnicity categories (mesor, IV, and M10;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.05 for interaction); associations for rhythm-timing metrics varied with age; and Shapley additive explanations analyses identified IS, RMV, and amplitude as 3 of the most influential RAR factors in epigenetic age acceleration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260351-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this exploratory cross-sectional study, higher strength and stability of circadian RARs were associated with lower acceleration of epigenetic age (particularly GrimAge and PhenoAge), whereas greater irregularity and more variable activity timing were associated with greater acceleration, supporting the interpretation of RARs as markers of biological aging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.11474","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T15:30:28Z","timestamp":1778167828000},"page":"e2611474","source":"Crossref","is-referenced-by-count":0,"title":["Twenty-Four\u2013Hour Rest-Activity Rhythms and Epigenetic Age Acceleration in Middle-Aged and Older Adults"],"prefix":"10.1001","volume":"9","author":[{"given":"Chunyu","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David 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Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel D.","family":"Callow","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia A.","family":"Munro","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keenan A.","family":"Walker","sequence":"additional","affiliation":[{"name":"Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan-ping","family":"Weng","sequence":"additional","affiliation":[{"name":"Laboratory of Molecular Biology and Immunology, National Institute on Aging, National Institutes of Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Ferrucci","sequence":"additional","affiliation":[{"name":"Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam P.","family":"Spira","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Johns Hopkins Center on Aging and Health, Baltimore, Maryland"},{"name":"Department of Psychiatry and Behavioral Sciences, Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brion S.","family":"Maher","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Johns Hopkins 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